Pennsylvania Gov. Tom Corbett's Medicaid plan filing could be ready

HARRISBURG, Pa. (AP) — Gov. Tom Corbett’s administration appeared ready Wednesday to submit its proposal to draw down billions of Medicaid expansion dollars under the federal health care law to help hundreds of thousands of working adults buy insurance.

An administration spokesman, Jay Pagni, would not say whether it would submit the proposal Wednesday to the U.S. Centers for Medicare and Medicaid Services. But groups of medical professionals and business associations say they have been told to expect the filing, while details of it have apparently been shared with some.

The administration has been reviewing public comments on its plan after issuing an initial draft in December. In the meantime, Corbett has been criticized for not moving sooner to draw down the federal Medicaid expansion dollars when they became available Jan. 1, as well as for aspects of his plan that advocates for the poor and uninsured say will discourage people from signing up for insurance.

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Corbett, a Republican and a Medicaid critic, refuses to use money made available under the 2010 health care law to expand Medicaid, the five-decade-old federal-state program to care for the poor and disabled.

He criticizes Medicaid as bloated and inefficient and prefers to use an idea pioneered last year by Arkansas to use the Medicaid expansion money to subsidize private health insurance for newly eligible Pennsylvania adults.

Such a change will need the federal government’s approval, but Corbett maintains that his proposal encourages personal responsibility and healthy behavior, and harnesses the ability of private insurers to better tailor benefits to a person’s health needs.

His administration also says it would save Medicaid dollars money because private insurers would take over the work of administering the policies while getting more people into the private insurance market will help bring down premiums for everyone else in it.

Advocates for the poor and uninsured have criticized Corbett’s December proposal as unnecessarily punitive toward potential enrollees, laden with red tape and unwisely cutting back benefits through the traditional Medicaid plan. They cited a long list of requests for the federal government to waive rules that would otherwise apply to the health care coverage that a state Medicaid program must provide.

Corbett wanted to eliminate all co-pays but one in favor of a new premium structure that requires many able-bodied, working-age enrollees to pay a monthly premium to keep the coverage or risk losing it for up to nine months. Those premiums can be reduced if the enrollee pays on time and completes an annual health risk assessment and physical, but the administration also wants the ability to change or expand that list.

A health screening questionnaire would determine whether someone has any complex medical conditions, and the state would determine whether a person is a high risk, and thus eligible for a broader benefits package, or a low risk, and subject to a narrower benefits package.

Corbett also wanted to require the able-bodied who are working under 20 hours a week to meet certain work-search goals, including engaging in 12 job-searching activities each month. Someone who fails to meet the benchmark would lose the coverage.